Ms Fatima Ayodele Lah, FNP is a medicare enrolled "Nurse Practitioner - Family" in Ajo, Arizona. Her current practice location is
410 N Malacate St, Ajo, Arizona. You can reach out to her office (for appointments etc.) via phone at
(520) 387-5651.
Ms Fatima Ayodele Lah is licensed to practice in Arizona (license number 242454) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1477053338.
Provider's Profile
| Full Name | Ms Fatima Ayodele Lah |
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| Gender | Female |
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| Speciality | Nurse Practitioner - Family |
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| Location | 410 N Malacate St, Ajo, Arizona |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1477053338
- Provider Enumeration Date: 02/17/2018
- Last Update Date: 09/18/2024
Medicare PECOS Information:
- PECOS PAC ID: 1052782224
- Enrollment ID: I20230126000445
Medical Identifiers
Medical identifiers for Ms Fatima Ayodele Lah such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1477053338 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 363LF0000X | Nurse Practitioner - Family | AP144807 (Texas) | Secondary |
| 363LF0000X | Nurse Practitioner - Family | 242454 (Arizona) | Primary |
| 163W00000X | Registered Nurse | 883859 (Texas) | Secondary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Ms Fatima Ayodele Lah allows following entities to bill medicare on her behalf.
| Entity Name | Gila River Health Care Corporation |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1376538231
PECOS PAC ID: 0648174185
Enrollment ID: O20031125000648 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Ms Fatima Ayodele Lah is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Ms Fatima Ayodele Lah, FNP
410 N Malacate St,
Ajo, AZ 85321-2254
Ph: (832) 455-6678 | Ms Fatima Ayodele Lah, FNP
410 N Malacate St,
Ajo, AZ 85321-2253
Ph: (520) 387-5651 |
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